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622 Congenital Cystic Adenomatoid Malformation: is it Always Bad News?
  1. K Yadav1,
  2. D Vasudev1,
  3. J Budd2,
  4. A O Akuma1
  1. 1University Hospitals of Leicester
  2. 2University of Leicester, Leicester, UK

Abstract

Aim To evaluate whether conservative approach to management of asymptomatic neonates with antenatal diagnosis of congenital cystic adenomatoid malformation of the lungs (CCAM) is safe and appropriate.

Method We undertook a retrospective review of all cases with antenatal diagnosis of CCAM from 2004–2010 in a lead perinatal centre. Pertinent data was extracted and the outcome and management of all affected infants were reviewed up to 1year of age.

Results Twenty-six pregnancies were complicated with CCAM. Three pregnancies were excluded: two terminated and one fetus had bronchogenic cyst. Twenty-three singleton pregnancies were included in the study. There was a threefold increase in CCAM in the last two years of the study as compared to the first two years. CCAM lesions underwent complete resolution in four (17%) fetuses, partial resolution in 12 (52%), remained static in four (17 %) and increased in one (4%) fetus. Eleven (48%) fetuses did not have any associated complications. 15 (65%) infants were asymptomatic at birth and eight (35%) were symptomatic. In two symptomatic infants respiratory distress resolved spontaneously. Three symptomatic infants had surgery and one died. A further three symptomatic preterm infants died due to extreme prematurity. All the surviving, non-operated infants: 17 (74%) were followed up and none required hospitalization or surgical interventions in infancy.

Conclusions Our study shows that conservative management of asymptomatic infants with CCAM; consisting of symptoms surveillance, radiological investigations and consideration for surgery if symptoms arise and persist is safe and may be more appropriate to elective surgery in infancy.

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